Asthma and bronchiectasis exacerbation.
Eur Respir J. 2016 Apr 13;
Authors: Mao B, Yang JW, Lu HW, Xu JF
Abstract
Bronchiectasis and asthma are common respiratory diseases worldwide. However, the influence of asthma on bronchiectasis remains unclear. The objective of this study is to analyse the effects of asthma on bronchiectasis exacerbation.Data from inpatients diagnosed with bronchiectasis with or without asthma at Shanghai Pulmonary Hospital (Shanghai, China) between January 2013 and December 2014 were retrospectively collected and analysed. 249 patients with only bronchiectasis and 214 patients with both bronchiectasis and asthma were included in the study. Follow-up records were used to evaluate the effect of asthma on bronchiectasis exacerbation.The variables found to be independently associated with bronchiectasis exacerbations were age (OR 1.07, 95% CI 1.03-1.11; p<0.001), duration of symptoms (OR 1.06, 95% CI 1.03-1.09; p<0.001), the presence of asthma (OR 2.6, 95% CI 1.15-5.88; p=0.021), forced expiratory volume in 1 s <50% predicted (OR 4.03, 95% CI 1.75-9.26; p=0.001), isolation ofPseudomonas aeruginosain sputum (OR 2.41, 95% CI 1.00-5.79; p=0.05) and lung lesion extension to more than two lobes (OR 2.73, 95% CI 1.16-6.45; p=0.022).The existence of asthma was associated with an independent increase in risk of bronchiectasis exacerbation.
PMID: 27076584 [PubMed - as supplied by publisher]
Definition of a COPD self-management intervention: International Expert Group consensus.
Eur Respir J. 2016 Apr 13;
Authors: Effing TW, Vercoulen JH, Bourbeau J, Trappenburg J, Lenferink A, Cafarella P, Coultas D, Meek P, van der Valk P, Bischoff EW, Bucknall C, Dewan NA, Early F, Fan V, Frith P, Janssen DJ, Mitchell K, Morgan M, Nici L, Patel I, Walters H, Rice KL, Singh S, Zuwallack R, Benzo R, Goldstein R, Partridge MR, van der Palen J
Abstract
There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management experts using Delphi technique features and an additional group meeting.In each consensus round the experts were asked to provide feedback on the proposed definition and to score their level of agreement (1=totally disagree; 5=totally agree). The information provided was used to modify the definition for the next consensus round. Thematic analysis was used for free text responses and descriptive statistics were used for agreement scores.In total, 28 experts participated. The consensus round response rate varied randomly over the five rounds (ranging from 48% (n=13) to 85% (n=23)), and mean definition agreement scores increased from 3.8 (round 1) to 4.8 (round 5) with an increasing percentage of experts allocating the highest score of 5 (round 1: 14% (n=3); round 5: 83% (n=19)).In this study we reached consensus regarding a conceptual definition of what should be a COPD self-management intervention, clarifying the requisites for such an intervention. Operationalisation of this conceptual definition in the near future will be an essential next step.
PMID: 27076595 [PubMed - as supplied by publisher]
Impact of viral infection on acute exacerbation of asthma in out-patient clinics: a prospective study.
J Thorac Dis. 2016 Mar;8(3):505-12
Authors: Liao H, Yang Z, Yang C, Tang Y, Liu S, Guan W, Chen R
Abstract
BACKGROUND: The prevalence of viral infection triggering asthma exacerbation and its impact on the symptoms and duration of exacerbation are unclear.
METHODS: Asthma and healthy control subjects were recruited from the First Affiliated Hospital of Guangzhou Medical University between February 2012 and February 2013. Nasal swabs were collected, and respiratory viruses were detected by polymerase chain reaction (PCR). All patients completed questionnaires and a lung function test. Some were followed up for 4 weeks, and symptom changes were evaluated via asthma diaries.
RESULTS: In total, 70 patients with acute asthma exacerbations were recruited. Among them, 34 patients (48.6%) completed the 4-week follow-up study. Another 65 patients with stable asthma and 134 healthy volunteers were also included in this study. The rate of positive viral detection via PCR in acute asthma exacerbation patients was 34.2% (24/70), which is significantly higher than that of stable asthma (12/65; 18.5%; P=0.038) and normal control patients (18/134; 13.4%; P<0.001). Among the viral-positive subjects, the number of viral copies was significantly higher in acute asthma exacerbation patients [(5.00±4.63) ×10(7) copies/L] (mean ± SD) than those in stable asthma patients [(1.24±1.44) ×10(6) copies/L; P<0.001] or in healthy controls [(1.44±0.44) ×10(6) copies/L; P<0.001], whose viral loads were not significantly different from one another (P=0.774). During the 4-week follow-up period, the cough scores on days 1 and 3 were significantly higher in the viral-positive group than in the viral-negative group (day 1: P=0.016; day 3: P=0.004). However, there were no significant differences between these two groups for other tested symptoms, such as dyspnea and total recovery time (P>0.05).
CONCLUSIONS: Respiratory viruses may be involved in acute asthma exacerbations, inducing more prominent and persistent cough symptoms.
PMID: 27076947 [PubMed]